1. Preparing for Quality: The Journey Towards Excellence
An Outcome Based Quality Improvement Tool
Rosemary Hurtley
Paul Kaye

2. OUTLINE OF THE MORNING Introduction to person centred outcomes (The 360 Standard Framework demonstration) – Coffee break Short film: Conversations that Matter Relatives- your hidden asset in quality dementia care Learning organisations, leadership and engaging people on the journey towards excellence & continuous improvement

3. Relationship Activated Care: The 360 Standard Framework Defining and Transforming Care Cultures
Using measurable outcome standards to exemplify and protect Human Rights in care settings
Patricia Duff OBE, MSc, BA, RN, RM, PGCEA
Rosemary Hurtley MSc, Dip COT, FRSA 3 3

4. Diagnostic assessment Consultancy, education & learning services.
360 Forward provides :
Diagnostic assessment
Consultancy, education & learning services.
Working with managers and staff at all levels across health and social care
Our aim is to establish dynamic, sustainable person centred cultures in their organisations in line with the philosophy and principles of the 360 Standard Framework.
360 Forward promotes and supports the fundamental tenet that:
positive relationships between the person, their relatives, staff and health professionals …..
….. is a defining and necessary characteristic of good care in all health and social care settings
Refer to what 360 does – audit ,consultancy advice and training to deliver it
The work 360SF and its supporting tools, products and services, enshrines Human Rights, issues around privacy, and exemplification of conceptual issues - dignity, compassion, being treated with respect and kindness and to feel included and understood in meaningful relationships in the community in which they live or residing.
Care settings should be viewed as communities in which positive relationships between and among the cared for person, their relatives and staff are essential characteristics of good care.
Pat and Rosemary realised that it would be possible to measure culture based on evidence, as the basis for continuous improvement taken from the perspective of residents, staff and relatives (relationship triangle) starting from first principles. Combining their MSc theses and literature research for residents.
Highlighting learning needs for sector in leadership and management and practice development 4 4

5. Mission & Philosophy of the 360 Standard Framework
Our Mission:
To make care homes a positive option for older people and their families where the services of a care home are needed. Establish The 360 Standard Framework as the leading quality standard for relationship activated care and community living in care homes and domiciliary services for older people throughout the care sector.
Our Philosophy:
Older people should have the same Human Rights as other people. They are entitled to personal privacy, dignity and to be treated with respect and kindness, to feel included and understood in meaningful relationships in the community in which they live.
Care settings should be viewed as re-created communities in which positive relationships between and among the cared for person, their relatives and staff are essential characteristics of good care. 5 5

6. What is the 360 Standard Framework?
A diagnostic assessment framework that shows care organisations how to establish and maintain person-centred cultures from the perspective of the cared for person, their families and carers
An outcomes based practice development framework for achieving continuous improvement
The 360 Standard Framework is a quality improvement (change management) framework born out of the desire to improve the quality of care for older people, the experience of visiting family members and staff at work. It comprises three sets of interdependent outcome standards, which together constitute a level of person centered practice as defined by the resident, the staff and the relatives.
Made up of 3 different although interdependent sets of outcome standards, reflecting what older people in care homes, their relatives and staff use to judge the goodness of a care home
A key feature of this methodology is that it is diagnostic. It not only identifies what is happening in the care home/care setting but also seeks to elicit why it is happening and prompts action on findings: it enables the analysis of options for resolving issues and the opportunity to select the best known practice increasingly evidence based practice for achieving improvements.
It can be used at all levels of organisation and practice to identify performance outcomes and ongoing development priorities over time in meeting the requirements of the 360 SF. As such it is both a triad of outcome standards and an assessment framework.
Dignity (DH 2006)
Human Rights (2011)
Relationship-driven person-centred care (2006/8)
Person-centred culture and practice (2007)
Compliance with standards using outcome measures (2008)
Think Local, Act Personal SCIE 2011
National Dementia Strategy / End of Life Strategy 6 6

7. The Relationship Triangle
The Principles of the 360 Standard Framework
Personalised care is dependent on a partnership approach, creating positive relationships.
Residents will judge their experiences more positively if management and staff are person- centred in attitude and behaviour.
Relatives will judge their experiences more positively if managers and staff recognise their roles and respond with understanding.
Staff will judge their working experiences with older people as more satisfying and worthwhile, and will be more person-centred in their work, if they feel valued and equipped to fulfil their caring roles.
The 360 Standard Framework is achievable where owners, managers and staff are committed to making it happen in partnership with residents and relatives.
Resident
Staff
Relatives
The Relationship Triangle
Relationship
Activated Care
These principles highlight the focus of the Standard and are the main tenets upon which the standards have been constructed
The 360 SF (CCS) comprises a quartet of 15 evidence based interdependent outcome standards and the measures of their achievement from the interrelated perspectives of the service users, family carers and supporting staff along-with the management requirements that enable its adoption.
Personalised care is dependent on a partnership approach, creating positive relationships.
Residents will judge their experiences more positively if management and staff are person-centred in attitude and behaviour.
Relatives will judge their experiences more positively if managers and staff recognise their roles and respond with understanding.
Staff will judge their working experiences with older people as more satisfying and worthwhile, and will be more person-centred in their work, if they feel valued and equipped to fulfil their caring roles.
The 360 Standard Framework is achievable where owners, managers and staff are committed to making it happen in partnership with residents and relatives. 7 7

8. The 360 Standard Framework exemplifies: Human Rights in care settings
Empathetic communication
Positive relationships
Gives providers the tools to develop:
Caring supporting communities for individuals, generating for the cared for person, their family carers and staff, a sense of security, continuity, significance, purpose, belonging and achievement (After Nolan et al 2003: The Six Senses Framework)
The 360 SF underpins all service and practice standards
Exercise: look at 3 communities model, which type of company are you in currently. Can you recognise the others from the past?
The 360 SF is a framework for establishing and maintaining person-centred cultures in care homes and other care settings, as places where older people who need them want to be, staff find the work fulfilling, and relatives and friends enjoy visiting. It is based on the premise that person centred practice requires positive relationships between and among the cared for person, their relatives and staff where the resident or client is always the central player.
The 360 SF exemplifies the human rights of the cared for person and the requirements of empathetic communication in the care giving relationship as measurable outcomes. It gives care providers the tools to develop caring, supportive communities that generate a sense of belonging, continuity, purpose, significance, security, and achievement (1) for the cared for person, their relatives and staff. It is interesting that Nolan’s Six Senses Framework fits rather well as a conceptual framework
Through creating positive relationships, care providers put the cared for person at the centre of how they measure success.
As such the 360 SF underpins all service and practice standards 8 8 8

9. Defining and Transforming
the Care Experience
The 360 Standard Framework creates cultures where:
people want to live
staff enjoy working
relatives enjoy visiting
…. and where managers and leaders facilitate relationships and community building with high quality care
Make care homes a positive option for older people and their families where the services of a care home are needed.
Success relies on: WHAT DOES GOOD LOOK LIKE?
Facilitative management and leadership
Continuous on the job support and development
The involvement of residents and family carers
Skilled and knowledgeable committed management

10. Exercise
Identify 4-5 measures people felt were most important to them and will use to judge their experience:
Residents
Relatives
Staff
Exercise:
When the research for the 360 SF began people were asked what was important to live, work and visit care homes; what key things did residents, staff and relatives say where of most important for them to have the best experience.

11. Assessment Framework –
Residents' Measures
Receiving person-centred care
Opportunities for social/occupational activity
Influencing meals and drink
Meeting spiritual needs
Resolving concerns and complaints
Next we are going to take a walk through the standard/assessment framework
Exercise:
Hand outs of the standards and outcome measures for R/RL/S/M. Talk through and relate into Standard 2. Then go through them on slides 9, 10, 11.
There are 5 standards and three outcome criteria for each section. The example above shows 5 key aspects of being in a care home of particular significance to residents. The audit will provide evidence to demonstrate achievement of the standard, and opportunities to agree and take action on improvements.
So what does dignity look like for a resident?
Person Centred Care and Support
Involvement in decision making
Acceptability of care standards
Confidence in end of life care
Experiencing communication and positive regard
Building positive relationships between and among the resident, their relatives and the staff:  
Home life and occupation
Meaningful occupational activity
Evolving positive relationships between and among resident, staff and relatives
Positive dining experience, companions, level of assistance required
Acknowledgement of spiritual life, someone to talk to
Talk about mapping to CQC Standard and how it prevents safeguarding

12. Domiciliary Care: Clients
Main themes for clients:
Control over decisions
Receives consistent care and support
Care and support is delivered in acceptable ways to acceptable standards
Positive relationships
Empathetic and effective communications
Able to resolve concerns and complaints without fear of retribution
Control over decisions about personal care and support (as far as capable)
Client receives consistent care and support from known care workers
Client feels care and support is delivered in acceptable ways to acceptable standards
Positive relationships between the client, care workers/professionals, managers and informal carers
Client experiences empathetic and effective communications between themselves and care workers, professionals, agency managers and social services
Client is able to resolve concerns and complaints without fear of retribution

13. Staff and Relatives’ Measures
Relative measures
Staff measures
1. Finding the work fulfilling
1. Welcoming ambience of the home
2. Having time to deliver good care
2. Communicating with staff and managers
3. Equipped to do the job
3. Being fully informed
4. Feeling valued as a staff member
4. Seeking to resolve concerns and complaints
The 360 – what does it look like?
Enabled to give Person Centred Care and Support
Integrated member of the resident’s care and support team
Positive relationship building between and among residents, staff and relatives
Pace and work organisation tailored to residents’ needs and abilities
Ability to respond to challenging situations at work- challenging events in the staff-resident relationship
Supported on-the-job learning and practice development for required competences
Relatives visiting experience
Involvement in decisions about the resident’s care and support
Acknowledgement of relative’s feedback role on care quality and home life
Acknowledgement of relative’s involvement in caring tasks
SF applies equally to domiciliary care (slides at end if needed)
LEARNING NEEDS FOR STAFF , Understanding ageism in society, Understanding chronic conditions and their effects on the person –identity, significance, continuity, purposefulness, belonging and being understood, Building positive relationships –the triangle, Specialist communication skills, Understanding transition, loss and adapting, Understanding and preventing institutionalisation, Inter professional co-operation and collaboration
Learning needs in these areas came up in different ways from residents, staff and relatives e.g. ‘I wish I knew more about communicating with people with dementia). Several felt this was not dealt with in enough depth. In fact this concern was voiced about other areas of learning e.g. relationship building, and being able to help people who were grieving, whether residents were grieving the loss of their home or the loss of a loved one with the sometimes stressful changes this brought, and the emotional engagement of staff in coping with the deaths of residents they had become attached to.
Many staff were concerned about he low status that older people have in society and the media at large e.g. language, stereotyping (sweet old thing, old codger etc). Obviously how this expresses itself in care homes is an ever present issue for trainers and training establishments.
Finally the effects of institutionalisation is well documented in research (e.g. Re evaluation of Residential Care, Sheila Peace et al) but insufficiently represented in training curricula for care homes.
5. Contributing to the care of the family member and the community of the home

14. Managers making it happen
Enabling /facilitative management style - clear channels of communication, positive relationship building, collaboration with other professionals and agencies
Pivotal leadership role in change management
Operational management
Practice development
Quality improvement
Business planning
After 9, 10, 11.
Exercise:
Tea making / cake making to give delegates opportunity to work through a standard and SPOs.
Management Enabling the 360 Standard Framework
requires a model of care management and support for example a named nurse and key worker to provide consistency and continuity
nursing management function strengthened to enable sustained person centred practice
leadership responsibilities strengthened with downward devolution of accountabilities and authority, and systemised individual training plans and programmes
senior staff facilitating practice development and meeting change agenda
facilitating quality of life outcomes by integration of activities into care plans to involve care staff responsibilities
professional and practice continuous quality improvement.
Management role in enabling adoption of the 360 Framework
Managers’ enabling staff to deliver the outcomes
Facilitative management approach
Empathetic communication skills
Pivotal leadership role in establishing the home’s relationship-activated person-centred culture
Infrastructure and processes support delivery of 360 framework for care homes, e.g. staff deployment models and continuity of care, integration of personal care and activities planning enhancing home life.
Quality assessment identifying practice development and learning needs.
 Operational management: demonstrate planning, organising service delivery, developing models for care delivery and the development of community life
Practice development –demonstrate education and training strategy, training methods and evaluation of outcomes.
Quality improvement strategy, QI plans and methods of delivery, involving residents, relatives, staff, informing practice development and training plans.
Business planning incorporating key result areas for service delivery, practice development and training, quality improvement and value added business performance.
What they need to know
Skilled in learning methods
Facilitation and group dynamics, listening, valuing
Knowledge and skilled use of an outcomes framework e.g. The 360 SF
QI action planning and project management
Setting project outcome standards
Open, facilitative pivotal leadership roles

15. These are what people experience as a consequence of delivering standard.

16. Characteristics of the 360 Standard Framework
Delivers continuous quality improvement and demonstrates measurable change
Involves the cared-for person, relatives and staff
A Standard of excellence in relationship activated care for person-centred outcomes
Underpins all other service and practice standards
Incorporates evidence from research and empirical studies
Diagnostic with measurable outcomes
The adoption of the 360 Standard framework is essential to good care and support in all Care settings for vulnerable adults in whatever settings they are or live
Summary of key features of 360 SF (CCS)
Characteristics of the 360 SF
A Standard of excellence in relationship activated care for person-centred outcomes
Measures the culture, organisation and services against rigorous specified requirements
Underpins all other service and practice standards
Incorporates evidence from research and empirical studies
Diagnostic with measurable outcomes on a continuum.
Delivers continuous quality improvement and demonstrates measurable change
Expresses outcomes from the perspectives of the person using services, relatives and staff
Is a catalyst for involvement of person using services, relatives and staff in the change process
Analyses both good performance and the reasons for underperformance enabling solutions to be identified and implemented.
Makes quality in care services visible to the user of services and their close relatives. 16 16 16

17. Outcome Standard Cont. Relevant Understandable Measurable Behavioural
Achievable
What is an outcome standard: An outcome standard comprises an agreed objective of care or support from the perspective of the recipient and the measures of success by which its achievement will be judged. The standard must reflect what research (or, in its absence, expert opinion) has established as good practice.

18. SPO Example : Resident Standard 3:1 The resident has a choice of culturally acceptable food and drink that meet his/her dietary requirements
Structure
Process
Outcome
What is an outcome standard: An outcome standard comprises an agreed objective of care or support from the perspective of the recipient and the measures of success by which its achievement will be judged. The standard must reflect what research (or, in its absence, expert opinion) has established as good practice.
Structure Criteria (The resources) e.g. competence, demonstrable skills, practice development, continuous education, testing new staff adequately, effective organisation, equipment
Process Criteria (What people do): staff action/decision-making involvement of residents and others, whether best practice method used for need
Outcome Criteria: (What you expect) client perspective - measures of desired effects of care
S- training programmes cover all aspects of nutrition relevant to the health and cultural profile of the resident including physical and mental capacity, empathetic commutation and listening skills, skills in engaging the resident in the decision-making and participation in meeting their nutritional needs
P –Designated staff record the resident’s significant nutritional details in the care plan taking account of a) health needs and b) hydration c) elimination d) requirements for assistance

19. Structure, Process and Outcome Criteria
What actions must staff take (processes) to achieve the specified outcome criteria of the particular standard? Who? How?
What structures and resources will be required to make it possible for staff to undertake the actions necessary for achieving the outcome?

20. 1 - Client Decision
360 SF Adoption Cycle
2 - Preparing and Planning
8. Internal Evaluation
Foundation Commitment Award
Foundation Outstanding Progress Award
6. Action
Plan
7. Internal Implement Action Plans.
3 - Data Collection
4 - Data Analysis
We are currently in the process of remodelling this cycle to make it more accessible for organisations to adopt the standard in a smaller incremental way.
Identifying which 360 SF (CCS) Service user Standard to adopt, taking planned action, measuring success.
This approach begins with the organisation deciding which 360 SF Service user’s Standard to adopt first and how to achieve that objective. 360 FWD provides tailor made packages for each of its tools, which contain instruction and support hours, to enable the agency’s adoption of the Standard.
The organisation then repeats the process on a continuum for each subsequent Service user Standard they wish to adopt. The involvement of 360 FWD reduces as the agency’s staff and managers become self-sufficient in self-assessment, project management, facilitating change and using action learning methods. This means the journeys become easier and easier to take and complete as the well-trodden pathways become second nature. In this way the 360 SF (CCS) becomes embedded in the culture and everyday practice and management of the agency (this applies in all health and social care settings).
Where the provider organisation owns several services such as agencies and care homes it has the opportunity to involve members of its central management team or members of the management team of another service in the project. Viewed as an action learning objective, this approach can be a very effective way of assessing the kinds of support managers, staff and other contributors need to succeed both in the agency and the wider organisation as the initiative is ‘rolled out’ over time.
360 FWD provides initial learning in how the 360 SF (CCS) works and how to use it and provides learning support thereafter tailored to the needs of the agency on a planned basis. This can include helping the agency to set up its Q.I. organisation such as its Q.I. working group and the communication network through which it will work if they don’t exist already.
5 - Feedback

21. 360 Cloud
Provides an electronic system for data storage of compliance against 360SF
A management tool to load data; build action plans; track, monitor and report on progress
Maintain a history of outcomes achieved
Demonstration

22. Session 3 Preparing for Quality: The Learning Organisation
An Outcome Based Quality Improvement Tool
Rosemary Hurtley

23. Example of 360 Standard Framework outcome measures
Resident Standard 2: Opportunities for social and occupational activity. Able to take part in meaningful occupational opportunities in and out of the home community, compatible with personal lifestyle, interests, activity preferences enjoyment and capabilities
Given opportunities to identify and agree
personal social/occupational needs (lifestyle)
Able to undertake both planned and spontaneous
meaningful social/occupational activities
Feels included as a valued member of the
community of the Home
How it works at the coalface:
Outcome criteria example
What does this look like for the resident?
Home life and occupation
Meaningful occupational activity
Evolving positive relationships between and among resident, staff and relatives
Positive dining experience, companions, level of assistance required
Acknowledgement of spiritual life, someone to talk to

24. Collecting evidence: What is needed
Asking the residents, relatives, staff and managers
Observing relationships and interactions
Looking at records and relevant documents
Analysing findings to identify the strengths and shortfalls in meeting the outcomes, and the reasons for both
Decide what improvements are necessary, and how to achieve them
This slide gives an overview of the evidence needed for assessment. We will the last 4 steps in more detail when we cover the action planning in my next session with you.
Where are we now?
How do we manage and lead staff now?
What management style and methods monitoring and development do we use?
Do we facilitate learning and provide spontaneous on the job coaching?
What initiatives are going on and how are they organised and supported structurally?
What is promoting or deterring progress?
Are we achieving required person centred outcomes for the service user, family carers and staff?
GET STARTED Undertake systematic diagnosis:
Finding out ‘where are we now’ poses the question 'Where do we want to be?' Be realistic about this. It will be no good setting unattainable goals. However, deciding on a longer term goal with incremental goals to get to it over a predicted timeframe would be reasonable.
Next we have to ask the question: 'How are we going to get there’? This requires action plans and spells out how it will be implemented, whether we are getting there and ‘How will we know we have achieved the outcomes we set ourselves?’
A range of diagnostic frameworks are available to aid the thinking process. Two commonly used models, The 7 S’s, and S.W.O.T analysis models
Find out complexity with 7 s diagnostic or analysis swot Steps to devising a strategy Getting people, to come with you - adult learning. Short timescales for small projects using a developmental approach. Get buy in with steering group, objective setting and and action planning Give feedback to keep people on board with support and coaching on the job Schedule info sessions on progress and overcoming difficulties Finish with
Adult learning - beginning where people are at, using experiential, participative approaches, giving coaching support and so on. Wilson (1987) set out six purposeful stages of the adult learning model.
Psychological approaches to managing change achieve positive results
Adult learning methods promote learning and deliver required outcomes
Decide how to monitor progress, and evaluate the results
Steps to move forward and training

25. What does good look like?
Commitment driven from the top to core values
Senior team are familiar faces and drive quality improvement .
A person centred organisation
Measurement
How is an organisation responsive?
Efficient systems
Energising leadership
Energetic organisations
Commitment driven from the top to core values where the senior team are familiar faces and drive quality improvement . A person centred organisation develops team working, creating imaginative and simple solutions that are realistic, measurable time specific and achievable – and involves everyone in the solution
If there is no measurement it makes tasks unclear and unfocused
How is an organisation responsive? It listens carefully, changes and adapts, demands behavioural standards, trains and supports staff
Efficient systems process can be subsumed by a poor customer experience
Energising leadership breeds excited staff – the army steeps its leaders in 6 moths leadership training before they take on these roles
Energetic organisations inspires staff and supports them in their learning and development

26. Think how you will make changes...
How will you create awareness of the need for change?
How will you select an initiating group?
How will you engage staff responsible to accept the need for change? *
How will you get ownership of all affected by the change?
Practice development and training: What new knowledge and skills do staff need? Will staff need to behave differently to achieve required outcomes?
Will you need to make changes in how things are organised to make the changes work?
Are there resource issues you need to resolve?
Is the leadership style of managers and lead practitioners facilitative and open?
* adult learning model.
Recap in a summary: Let us quickly recap on what we have covered before we move onto Action planning. This helps everyone to refocus.
Action plans for achieving improvements: Factors to take into account:
(ppt slide 6)
Notes to lecture: Before we begin to design an action plan there are many factors to take into account.
Whilst people are excited about what the end result looks like, change management requires careful and realistic planning; all change strategies will present risk that need managing and here are some of the areas to explore at this Feasibility stage.
We are about to begin working through the 360FWD Action Planning Guidance but before we do we need to visit the Change House....
Group discussion: give out ‘the change house’ (handout), work in pairs to read through and enjoy! Do you recognise yourself at different times in your life? Does this bring a staff member to mind? This helps us to remember that our staff may have fears that need supporting. 5 mins
Think how you will make changes:
...use bullet points on slide.
**(Use the Adult learning Model, which starts where people are at, introduces new as modification of old, introduces new as single reasonable demand to build the total behaviour desired and involves a mandated leader with a working group of people from different levels of operation to carry it through). Developing people to where they want to be.
Exercise: Discuss in pairs/group and make notes ready for action planning, think how you might approach some of these issues that change will bring. Where people are unsure, get others to contribute their ideas (Facilitate not dictate)

27. Resolving organisational issues
Power and influence
Organisational structures and systems
Agreeing initiatives
Shared vision
Understanding quality improvement

28. The Adult Learning Model
Starts where people are at
Introduces the ‘new’ as a modification of the ‘old’
Introduces the ‘new’ as a series of single, reasonable demands that build to the total behaviour desired
Involves a steering committee of people from all levels

29. What are the key measures of a learning culture ?
Interlinked supporting structures and organisation
Spontaneous and pre-planned learning support
Clearly defined roles and responsibilities
Quality improvement and involvement of service users, family carers and staff
Box 1: Summary: Unique characteristics learning organization care home
Managers, leaders, practitioners strive continuously to discover best practice
Strive to implement best practice standards using action learning methods
Effective in developing the humane caring behaviours and professional expertise from service user and family carer perspectives
Deliver the person centred and socio-therapeutic outcomes statutory and professional bodies require
Deliver value added benefits to organization – better staff retention, lower recruitment costs, lower sickness/absence, higher occupancy, better income security and organization sustainability

30. Learning Culture Measures of Success
Facilitative management and leadership style
Using facilitation and coaching
Intermittent performance monitoring,
Spontaneous on the job learning support
Planned learning programmes for improving practice outcomes
Supporting planned learning implementation at work
Evidence of necessary knowledge, skills and behaviours
Evidence of improving socio-therapeutic and person centred outcomes
Evidence of compassionate culture from service user, family carers and staff

31. Work-based Learning Key topic areas For delivering compassionate care
Understanding ageism in society
Understanding chronic conditions and their effects on the person –identity, significance, continuity, purposefulness, belonging and being understood
Building positive relationships –the triangle
Specialist communication skills
Understanding transition, loss and adapting
Understanding and preventing institutionalisation
Inter professional co-operation and collaboration
Dignity challenge – zero tolerance of abuse, treating each person as individual, supporting independence, choice and control, respecting rights to privacy, acting to alleviate loneliness and isolation, enabling complaints without fear.
‘Dignity and respect are low aspirations on which to build a challenging agenda’ – instead base it on citizenship with increased focus on personal identity, self-expression and individual aspirations, rights and circumstances’. JRF Think Local Act Personal – more than personalised budgets
It’s hard to achieve –and much less likely to be recognised
The demand for evidence is wide ranging and multi-layered covering everything from environment and services to the quality of resident’s home life and the expertise required of staff and managers
Statutory regulation and inspection increasingly require care providers to produce evidence of outcomes
Elizabeth Care Approach to Learning:
Student involvement is key all the way through the course and is an active participant in learning
A person centred approach underpins learning
The role is about helping people with long term conditions to adapt and maximize their potential capabilities
Using adult learning methods in the workplace enables participants in a wide range of projects to acquire the expertise they need to achieve their contribution and sustain progress. This ensures that their personal and care skills are developed.
Learners reflect on their practice and identify areas of development
Organizations often waste money on training that makes little impact or change to the patient/resident experience. The difference is that the students learning is based on outcomes based assessment of what they do well, what needs to be improved, and what the organisation need to focus on.

32. What is needed We need something that:
Places the relationship triangle at the heart of management responsibility
Is flexible in its application
Shows staff and managers how to achieve measurable outcomes
Demonstrates care provider accountability for person centred organisational performance
Demonstrates investment in leadership, management and practice development
Promotes the validity of internal review with external assessment
We have found these characteristics apply in practice.
Advantages of the 360 SF
Places the relationship triangle at the heart of management responsibility
Is flexible in its application
Shows staff and managers how to achieve measurable outcomes
Demonstrates provider agency accountability for person centred organisational performance
Demonstrates investment in leadership, management and practice development
Promotes the validity of internal review with external assessment
Enables care organisations to achieve the 360 Foundation Certificate of Commitment and Progress and/or the 360 Foundation Certificate of Outstanding Progress
Management accountability for its performance as a person centred provider is made transparent
Makes good provider agencies visible for service users and their family carers.
 How it helps an organisation
Promotes self-management of QI
Facilitates analysis of training needs
Is a blueprint for education and training for self audit, practice development and change management
Helps care providers to meet CQC registration requirements
Makes good care homes visible for older people and their relatives 32 32

33. 39Q’s Outcomes Surveys Finds out what people really think
Includes unique Outcomes-based surveys, Community Support & Residential versions
Service User, Staff, Relatives & Friends surveys
Results compiled and displayed online
Results linked to CQC KLOE’s
Provides evidence for compliance / non-compliance

34. Jeremy Hunt, MP for South West Surrey & Secretary of State for Health said, "I want to make this the best country in the world to grow old – and that means continuing to do everything we can to improve a culture of compassionate care. This programme is a really important initiative and I look forward to seeing it develop further in the future.”
Anne Milton, former Health Minister and local MP in Guildford said, “As someone who trained as a nurse and worked in the NHS for 25 years, I am so impressed with all that has been achieved. This course is about making sure that older people get the care they deserve and recognising the critical role staff play in making that happen. Well done to everyone for their inspiration in getting Elizabeth Care on the map.”

35. Contacts
Rosemary Hurtley – 360 Forward Mob: Office: